Racism isa PublicHealth Crisis

What You Can Do

Do you agree it’s time to declare racism a public health crisis? Once this happens, what can we do as healthcare providers? Educators? Parents? Voters?

We have a lot of work to do to build awareness and offer a succinct plan to create the systemic change in American healthcare, and there hasn’t been a better time than now. But we need your support.

Here are some ways you can help our mission and our campaign, Right To Health Now!

Contact us if you’ve experienced or witnessed situations in your community that involve racism and accessing healthcare. This could be medical, hospice, alternative medicine, etc.

Portland has a longtime history with racism. Our city is quickly growing, for better or for worse. Is your neighborhood changing in ways that negate racist behavior or is the opposite happening? Contact your city council representative. Write you

We encourage you to share your experiences and opinions directly with Dr. Frieden at the CDC. Not sure what to write? President Obama’s website offers some great tips. When you’re done, send us a copy.

We’d love to hear your ideas on making America more tolerant to our already diverse population, particularly if you have expertise in healthcare of any kind. Please contact Leslie directly.

Let’s build a national coalition locally, together.

Sign The Petition

UCLA obstetrician and gynecologist Dr. Michael Lu believes that for many women of color, racism over a life time, not just during the nine months of pregnancy, increases the risk of preterm delivery. To improve birth outcomes, Lu argues, we must address the conditions that impact women's health not just when they become pregnant but from childhood, adolescence and into adulthood.

We’ve been following many groups over the years that have been gathering more and more research related to how health disparities are attributed to racism at all levels: personal, community, institutional.

When Unnatural Causes released the documentary, “When The Bough Breaks” several years ago, it was a groundbreaking documentary that captured what we always knew. But now, there’s measurable data that shows the pain of what Black Americans have endured. Regardless of class status. Regardless of pedigree. Regardless of location.

The cost of human life, irreparable mental, emotional and physical distress and millions of healthcare dollars are no longer sustainable. We want to fulfill the promise of our democracy for all so that all Americans in crisis are being cared for. Leslie presents the case here.

Where to start when we know at the highest levels, very few acknowledge racism is a health problem? Leslie decided to start with the Centers for Disease Control and Prevention (otherwise known as the CDC). Her letter is shared below along with the CDC's weak response.

While we weren't surprised at their response, we have met so many Americans who agree: racism IS a public health crisis. That's why we started Right To Health Now! We believe mobilizing Americans to send a very clear message to our national health institutions: the longtime denial of racism has been unmasked for what it is. It's “The Matrix” of our time.

We cannot truly be equal as Americans while our most respected health institutions subtly perpetrate ongoing oppression by not recognizing racism meets their own criteria.

This should not be political, this is about human rights and equity for all. For almost three years, this petition on MoveOn.org has been up to bring awareness and support to this cause.

If you agree racism is a public health crisis, please consider signing.

Letter to the CDC

Leslie Gregory, founder and director of Right to Health in Portland, Oregon, makes her case to the CDC (Center for Disease Control) for racism being a public health threat.

Last summer 2015, Leslie decided to write an open letter to the Centers for Disease Control and Prevention (CDC) asking for their commitment to declare racism a national healthcare crisis. The CDC is a powerful and highly influential federal organization responsible for tracking and solving healthcare issues throughout our country, and they are THE authoritative source for all healthcare monitoring and prevention work in the U.S

Their mission statement reads:

CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.

CDC increases the health security of our nation. As the nation’s health protection agency, CDC saves lives and protects people from health threats. To accomplish our mission, CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise.

Dear Dr. Frieden,I am a primary care provider, a Navy veteran, anti-racist health equity advocate, and singlemother of two. I am black, and I am a healer. I’ve spent more than 15 years helping people copewith a wide spectrum of health issues, particularly Black Americans.

My mother was a prominent nurse who was turned down for the largest hospital-based nursingprogram in Northwest Ohio because of her race. She graduated from St. Vincent’s School ofNursing, devoting her life to surgical, teaching and public health nursing. She and her peersstarted the Ohio Association of Black Nurses in response to the Ohio Association of Nursesrefusing her membership. My father was a firefighter. Despite risking his life in the service ofothers, he and his co-workers of color were not welcome in the Ohio State FirefightersAssociation. They started a branch of the International Association of Black Firefighters. Hefought fires on the streets and racism in the firehouse, which stresses contributed to his earlyheart attack at 45 and his demise from heart disease at 61.

My experiences and observations have shaped many ideals and beliefs which I hold dear today. Igrew up an activist, stuffing envelopes and encouraging my neighbors to register to vote. The civilrights movement brought hope. It brought the notion of breaking free from the confines of raceand racism as experienced by black people. Fifty years later, it is a promise unfulfilled.

Like many of my colleagues in healthcare, I look to CDC for guidance on public health policy andprevention. But I wake up every morning frustrated and perplexed by what the CDC fails toarticulate: racism is, and continues to be, one of the great public health threats this countryhas ever faced. The consequences range from disproportionately high rates of low birthweightbabies to heart disease and stroke to higher rates of school expulsion, deaths of unarmed peopleand high rates of incarceration.

This clearly meets the CDC’s own criteria for a formal, justified, public health problem:

The health condition must place a large burden on society, a burden that is getting largerdespite existing control efforts

The burden must be distributed unfairly (i.e., certain segments of the population areunequally affected)

There must be evidence that upstream preventive strategies could substantially reducethe burden of the condition

Such preventive strategies are not yet in place

Dr. Frieden, it’s time for the CDC to make a formal declaration: Racism has created andmaintains a public health crisis. As an American medical professional, my citizenship andexpertise entitle me to firmly request your assistance. Do you awake every morning, week afterweek, year upon year, as frustrated by our lack of progress?

Due to disparate treatment based on race, deaths and infirmities in communities of colorcontinue to climb at an alarming rate. This coupled with other health determinants such aseducation, employment and incarceration rates continue to exacerbate the problem and disturbthe collective American consciousness. This is a critical juncture in our society where itappears we can finally, FINALLY, address racism at the root and begin to heal. It would bemost appropriate to make this proclamation before our civil rights and minority health workersgive up hope. Let them trust that the CDC will take this significant step toward social justice andsocial well-being.

I too have chosen to take action. I share these frustrations felt by millions of Americans, many ofwhom cannot begin to express the stress. I write to you to announce my leadership with a new,national campaign called Right to Health Now! The intergenerational transmission of “lesserthan” affects us all at an epidemiologic level, for we are all connected, regardless of color. I amencouraged by how many people across the country have hit a collective, social resolve to makechange even if they are not sure where to start. For example, I have experienced a tremendousincrease of antiracist and trauma recovery activists in Portland, OR where I live. I have metothers in other cities across the country doing similar work because we MUST. We all ask thatthe CDC declares racism a threat to public health and make combatting racism a publichealth prevention priority. Please recognize and augment the efforts of Right To Health Nowand other similar grassroots efforts.

I respectfully request a response in the next 30 days. Thank you for your attention.

Leslie Gregory, PA-CRight to Health Now!leslie@right2healthus.org

The CDC Response

The CDC responded to Leslie on 10/23/15 by email. However (no surprise) it was not by Dr. Frieden:

Dear Ms. Gregory,

Thank you for your letter to Dr. Frieden expressing concern about the national response to the impact of racism on health. Indeed, there is a significant and growing literature on the impact of racism on health, and particularly among African Americans. In our work to address health equity, we have adopted the Department of Health and Human Services (DHHS) definition of health equity which clearly speaks to “….valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities.” Similarly, our engagement with Healthy People 2020 Social Determinants of Health topic area also includes “perceptions of discrimination and equity” as a social determinant of health. We have convened scholars, public health leaders and practitioners, and community leaders to chart a course toward achieving health equity, and racism is consistently named as undermining the health of communities of color. In addition, CDC supports government-wide policies to combat the effects of racial discrimination. These take the form of various Executive Orders (EO), which are targeted toward improving language access to services since 2000 (EO13166), increasing diversity and inclusion in the federal workplace since 2011 (EO 13583), and promoting the implementation of theNational Standards for Culturally and Linguistically Appropriate Services in Health and Health Care(CLAS Standards), to name a few. Addressing racism has been a central feature of a number of CDC-supported health disparities initiatives. One such example is CDC’s Racial and Ethnic Approaches to Community Health Program (REACH) in Genesee County, MI that is “undoing racism” as part of its public health efforts to reduce infant mortality among African Americans. See “Undoing Racism Through Genesee County’s REACH Infant Mortality Reduction Initiative” in Progress in Community Health Partnerships: Research, Education, and Action. Spring 2015; volume 9.1: 57-63.

As we have sought to understand the impact of race and racism on population health, the most important question is what is the role of public health in addressing racism. One of the most effective ways CDC can represent the relationship between racial discrimination and health outcomes is to highlight the persistent burden of racial and ethnic health disparities. One way CDC has highlighted these disparities is through a periodic CDC Health Disparities and Inequalities Report – United States, which was first published in 2011, and was updated in 2013. This resource has been used to call attention to emerging and persistent disparities in health.

Though we are engaged in efforts on multiple fronts to address the impact of racism, including research and surveillance, policy and partnerships, we recognize that there are limited evidence-based practices that we have identified to effectively disrupt structural racism. We welcome information about any strategies you or your organization have identified about what works. Racism and racial discrimination in health is a societal issue as well as a public health one, and one that requires a broad-based societal strategy to effectively dismantle racism and its negative impacts in the U.S.

Thank you for your efforts, as well as those of your organization, to raise awareness of the impact of racism on health.

While we appreciated Dr. Liburd’s reply, these words rang a bit hollow. Isn’t the CDC supposed to create strategies and research if there is supposedly not enough “evidence-based practices”? What exactly is “broad-based societal strategy”? Isn’t the CDC in a very powerful position to both create definitions and respond to them?

We welcome your thoughts. Suffice to say, for us, the seed has been planted for declaring racism a public health crisis.